Sharon Herrington of Schuylerville, center, and Ronnie Carrigan of Ballston Spa, right, shown here with Rubin Dialysis Center CEO Wayne Evancoe, left, work at the Rubin Dialysis Center in Saratoga Springs as nocturnal observers who monitor patients using portable dialysis machines at home. The two monitor about 30 patients in four states who usually visit the center once a month. (Ed Burke / The Saratogian)

SARATOGA SPRINGS -- For 40-year-old Caryn Derby of Greenwich, living with chronic kidney disease once meant giving up 12 morning hours a week to dialysis, which often left her tired and drained.

But now, thanks to the nonprofit Hortense and Louis Rubin Dialysis Centers' overnight therapy program, she can enjoy time with her family during the day.

The in-center nocturnal program lets patients come for dialysis three times a week any time between 8 p.m. and 5 a.m. Patients must stay for a minimum of six hours of dialysis to see results, so most of them sleep through the night in the center, monitored by a registered nurse and staff.

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Patients report feeling less tired and washed out when the treatment is finished because the overnight fluid removal is slower and therefore easier on the body.

"Dialysis took so much out of me at first," Derby said. "Being here at night, though, frees up my days. I just sleep through the treatment in my quiet corner."

Her corner is part of the 19-station Saratoga Springs Rubin center at 59C Myrtle St. The two other Rubin centers are at 1850 Peoples Ave. in Troy and at 21 Crossings Blvd., Suite B, in Clifton Park.

The centers serve 410 patients across New York, Connecticut, Massachusetts and Vermont, and 28 percent of them use home dialysis units.

Home patients and their families must be carefully trained in the treatment. Nurses monitor these long-distance patients from the centers, watching computer screens throughout the night.

"Our board and our talented, caring staff work to maximize patients' lives so they can spend their days working or with their families," CEO/Renal Administrator Wayne A. Evancoe said. "We have one 78-year-old nocturnal patient who can now play golf several times a week."

The kidneys are a pair of hard-working organs that filter waste from the blood, diverting these impurities to the bladder. Other functions include the regulation of electrolytes; the regulation of blood pressure by maintaining salt and water balance; and the re-absorption of water, glucose and amino acids.

Each of us needs at least one good kidney to function. Untreated kidney failure is fatal.

The good news is that treatment for kidney disease is available, often successful and even largely pain-free.

Rubin patient Michele Geissler, 51, of West Charlton doesn't like needles. She looks away when nurse Maureen Van Wormer sets up the overnight dialysis. For the overnight patients, having competent, caring medical staff is a comfort.

During dialysis, patients recline while two tubes are inserted into their body. The dialysis machine pumps their blood through a filter with a semi-permeable membrane that removes harmful waste, salt and excess fluid. The purified blood is then pumped back into the patient through the second tube.

Patients can sleep through the entire procedure or they can read, knit or watch TV. Quiet time starts at 10 p.m., when the lights are dimmed, and peace settles over the center.

Van Wormer and her staff, which includes patient care technician Alan Billings, monitor the patients all night.

"We make sure all the air is out of the dialyzer," Billings said as he set up the machine. "We program the computer with the patient's doctor's orders."

He grinned at Waters.

"The patients are good guys," Billings said. "They're like my second family."

Waters settled back, chewing gum and smiling. He has been undergoing dialysis for a year and a half.

"The brain takes a while to catch up to the body," he said. "In the beginning, you think, 'Why me?' But I knew I had to be here. Over time, I felt a lot better -- I don't feel sick at all now. I can do everything I want."

While Waters plays golf and goes to the casino, Derby helps her brother milk his cows and plays with her 3-year-old niece. Geissler volunteers at her church and helps her sister care for their 78-year-old mother, which includes lots of shopping trips.

"This nocturnal program has been a Godsend for me," Geissler said. "When I came for daily treatment, my blood pressure would bottom out and I would feel lousy. The nighttime session is longer and slower, so it's gentler on the body. And I can be sure of having dinner with my family."

Geissler, Waters and Derby all developed kidney disease through diabetes. Derby was diagnosed with Type I diabetes at age 12, while Geissler had gestational diabetes at age 29, leaving her at risk for full-fledged Type I, which came four years later. Twenty years ago, Waters was diagnosed with diabetes; his kidney failure began six years ago.

Geissler and Derby are on the kidney transplant list. Derby also needs a new pancreas. Despite disappointments, they continue to wait patiently.

"The kidney will come someday, and life will change again," Geissler said.